Beta agonist : reverse ASM contraction ->
Many simultaneous actions are taken to achieve the goals mentioned above.
One of which is medication.
Pharmacologic treatment is the mainstay of management in most patients with asthma.
Two options:
[!INFO] Initiation level Vs. adjustment
✳️ Level of initiation of controller medication -> determined by asthma severity. See below:
[[AsthmaControllerTherapy.png]] <- two parallel guidlines : GINA and NAEPP✳️ Adjustment of asthma therapy is done according to assessment of asthma control.
[[AsthmaControlAssessment.png]] <- based on GINAAsthma control has two domains: (see section A and B in the table)
- symptom control and
- risk of future exacerbations
Assess the symptom control domain by patient's recall of previous 4 weeks; assess risk of future exacerbations by the presence of risk factors and by spirometry/or peak flow measures.
Level of initiation is determined at first assessment.
Then treatment level is adjusted to achieve best control with minimum side effects.